Medical questions & health advice by board certified doctors
"Will they tell me if my body is accepting the new kidney at my kidney transplant follow up?"
How soon after the transplant will I know whether my body is rejecting the new kidney?
Congratulations on getting a kidney transplantation. Kidney transplants generally have a 90-95% success rate in the first year after transplantation. You will need to schedule follow-up appointments with your transplant surgeon, and with your nephrologist. Your nephrologist will routinely check blood tests, and potentially urine tests, to evaluate for the function of your new kidney. Keeping in mind the high one year success rate, the recipient's body can reject the transplanted kidney in about 5% of patients. Graft rejection can be divided into several subtypes: 1. 24 hours after transplant: Antibodies that are already in the recipient's bloodstream attack the transplanted kidney in the first 24 hours ("hyperacute rejection"). The surgeon can usually see this happen while in the operating room; they new kidney may change color and stop producing urine. It is diagnosed more definitively by biopsying the kidney. 2. 1 week to 3 months after transplant: the kidney can be rejected due to new antibodies against the kidney, or can stop working as well due to infection or recurrence of the initial disease. This is diagnosed by a blood test (creatinine) that looks at the kidney function. If the creatinine value is rising, that raises suspicion for rejection. 3. More than 3 months after transplant: if your immunosuppressive medication levels are too low, this can lead to kidney rejection. If the levels are too high, you can develop kidney damage from toxic levels of the medications. You should discuss your concerns with your nephrologist.
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